  <!------style assets   ---->
  <link rel="stylesheet" type="text/css" href="../CSS/loginpopup.css" media="screen" />
  <link rel="stylesheet" type="text/css" href="Assets/jquery-ui.css">
  <link rel="stylesheet" type="text/css" href="Assets/style.css">
  
  <!------jquery assets  ---->
  <script type="text/JavaScript" src="../Assets/jquery-1.10.1.min.js"></script>
  <script type="text/JavaScript" src="../Assets/jquery-1.9.1.js"></script>
  <script type="text/JavaScript" src="../Assets/jquery-ui-1.10.4.js"></script>
  <script type="text/JavaScript" src="../Assets/popup.js"></script>


<div class="toggler" id="effect">
	    <a href="#user-box" class="login-window">Additional Info</a>
		<div id="user-box" class="login-popup">

<!----start connector code -->
<form action="../dashboard/connector/connector_template.php" method="post" name="user_form" class="submit">
<!----end connector code -->

<fieldset>
<legend>Please Enter Your Details</legend>
<div>
<table width="100%">
  <tr>
    <td><label for="first_name">First Name:</label></td>
    <td><label for="middle_name">Middle Name:</label></td>
    <td><label for="last_name">Last Name:</label></td>
  </tr>
  <tr>
    <td><input type="text" name="first_name" value="" maxlength="100" /></td>
    <td><input type="text" name="middle_name" value="" maxlength="100" /></td>
    <td><input type="text" name="last_name" value="" maxlength="100" /></td>
  </tr>
</table>
</div><br>

<!-----------calendar code---->
<html lang="en"><head>
  <meta charset="utf-8">
  <title>Select your Birth Data</title>
  <script>
  $(function() {
    $( "#datepicker" ).datepicker();
  });
  </script>
</head>
<body>
<p>Date: <input type="text" id="datepicker"></p>
</body>
</html><br>
<!------------end calendar code------->

<div>
<label for="gender">Gender:</label><br>
<input type="radio" name="gender" value="male" /> Male
<input type="radio" name="gender" value="female" /> Female
</div>
<br>
<div>
<label for="send_email">Email Me:</label><br>
<input type="checkbox" name="send_email" value="news" /> Email Me News
<input type="checkbox" name="send_email" value="updates" /> Email Me Account updates
</div>
<br>
<div>
<label for="household_income">Yearly Household Income:</label><br>
<select name="household_income">
  <option value ="null">Please Select</option>
  <option value ="zero_to_ten_k">$0 - $10,000</option>
  <option value ="ten_k_to_fifty_k">$10,000 - $50,000</option>
  <option value ="fifty_k_to_one_hundred_k">$50,000 - $100,000</option>
  <option value ="over_one_hundred_k">Over $100,000</option>
</select>
</div>
<br>
<div>
<input name="submit" type="button" value="Submit" onclick="user_form.submit();" >
</div>
</fieldset>
</form>
</div>>